Operation Straight Spine Provides Spine Care to Needy Patients in the Third World

Molly Gamble -   Print  |
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Each year, Jeffrey McConnell, MD, and a team of approximately 10 nurses, anesthesiologists, neuromonitoring technicians and spine surgeons visit Kolkata, India, to treat underprivileged children and adults with spinal diseases and deformities. Dr. McConnell is co-founder of the charitable mission, known as Operation Straight Spine, which is the first project of its kind in India.

Dr. McConnell, who practices with OAA's Pennsylvania Spine and Scoliosis Institute in Allentown, co-founded OSS with Dr. Ujjwal Debnath, FRCS, who practices in the UK.* Dr. McConnell met Dr. Debnath while completing their fellowships at the Centre for Spinal Studies and Surgery, Queen's Medical Centre, in Nottingham, England. After extensive planning, the surgeons began visiting Kolkata through OSS in its 2006 pilot program and have returned each year since.

A five-year organization process
Since Dr. Debnath is based in the United Kingdom, Dr. McConnell spearheaded U.S.-based fundraising and recruitment. He founded the Spine Education and Research Foundation, a non-profit through which he solicited donors. Corporate sponsors of the program include Medtronic , Synthes, Globus Medical, DePuy Spine, 3M Medical Division, and NuVasive, among many others. He also recruited volunteer nurses and anesthesiologists.

Dr. Debnath, who is native to Kolkata and speaks the language, had to find an Indian hospital to host OSS. He began reaching out to sophisticated facilities, but many were not interested in lending their space pro bono. Finally, he found a hospital through the Ramakrishna Mission Seva Pratisthan, a well-known teaching hospital in Kolkata affiliated with the Ramakrishna monks.

All together, it took the team five years (2001-2006) to finalize a location, solicit donations, complete due diligence, meet equipment needs and meet other regulations. Before traveling to Kolkata to perform surgeries, the team first traveled to identify candidates for treatment.

"In the United States, the majority of patients with spinal disorders will be treated regardless of their ability to pay, but that's simply not true in other countries," says Dr. McConnell. Since OSS has limited resources, they must identify candidates for surgery and treat a select few, which Dr. McConnell calls the most "heartbreaking" aspect of the program. "It's painful to see people you know you can help, but you have to say no," says Dr. McConnell.

Adjusting care to Indian beliefs and customs
Culturally, Dr. McConnell and his team had to adjust their care to firmly-held Indian beliefs, such as that of reincarnation. "Someone told me, 'People will question you. They will ask why you want to help them,'" says Dr. McConnell. Many of India's impoverished believe spinal deformities or diseases are a "cross to bear," part of the way they were created, and their next life will be more fortunate.

"A doctor also told me that we have to charge them for something. If something is free, they think it's not worth anything," says Dr. McConnell. As a result, the team allows the patients to pay for however much they can afford. "They will pay for some of the consumable items such as drugs, IV fluids or bandages. Across the street is a medical supply store where they buy the things they may need for their hospital stay," says Dr. McConnell.

The surgeon-patient relationship is more complex, but still integral
The team stays for two weeks at a time, and the surgeries can last up to eight hours each. Dr. McConnell says the team tries to treat candidates who are unable to take care of themselves, cannot provide for their families and will see significant improvement in quality of life post-surgery. Although the procedures are performed in the third world, the team strives to use state-of-the-art equipment and techniques. For instance, the team used Bone Morphogenic Protein for spinal fusion, which was the first time it had ever been used in India. Other groundbreaking techniques include somatosensory evoked potentials, motor evoked potentials and electromyogram neurophysiological spine monitoring.

Since the team departs after 14 days, follow-up care and physician-patient relationships are sometimes difficult to navigate. Dr. McConnell says local orthopedic surgeons offer follow-up care and Dr. Debnath travels from the U.K. every three to six months for follow-up clinics in addition to the annual follow-up the team does upon its return to Kolkata.

As a result of his work in Kolkata, Dr. McConnell says he has noticed subtle changes in his relationships with patients in the states. "OSS is a topic of conversation now, and I think patients look at you a little differently. They don't think I'm some wealthy surgeon riding around in a Porsche, only in it for the money," says Dr. McConnell, who is the proud owner of a Volkswagen Jetta. "I've been privileged in my career, I make a comfortable living, and OSS is my way of giving back something to those less fortunate."

*Editor's note: FRCS stands for the Fellow of the Royal College for Surgeons, a professional qualification for practicing surgeons in the United Kingdom.

Learn more about Operation Straight Spine.

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